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NPI Code Detail

MEDICARE: CHRISTOPHER RUSS

MEDICARE: CHRISTOPHER RUSS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1374U00000XHome Health AideVA

General Provider Information

NPI Number : 1720594005
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER RUSS
Provider Business Mailing Address
First Line : 2702 PERDUE CT
Second Line :
City : CHESTER
State : VA
Zip : 23831-2149
Country : US
Telephone Number : 804-318-7978
Fax Number :
Provider Business Practice Location Address
First Line : 2702 PERDUE CT
Second Line :
City : CHESTER
State : VA
Zip : 23831-2149
Country : US
Telephone Number : 804-318-7978
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2017
Last Update Date : 06/16/2018

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Directions to “ CHRISTOPHER RUSS ” Practice Location

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